David DiSalvo is the author of "Brain Changer: How Harnessing Your Brain’s Power to Adapt Can Change Your Life" and the best-selling "What Makes Your Brain Happy and Why You Should Do the Opposite", which has been published in 10 languages. His work has appeared in Scientific American Mind, Forbes, Time, Psychology Today, The Wall Street Journal, Slate, Salon, Esquire, Mental Floss and other publications, and he’s the writer behind the widely read science and technology blogs “Neuropsyched” at Forbes and “Neuronarrative” at Psychology Today. He can be found on Twitter @neuronarrative and at his website, daviddisalvo.org. Contact him at: disalvowrites [at] gmail.com.

Is Malcolm Gladwell Right, Should College Football Be Banned To Save Brains?

Journalist and best-selling author Malcolm Gladwell is an outspoken advocate of banning college football on health grounds, and his appearance on CNN’s ‘GPS with Fareed Zakaria‘ has turned up the volume another notch. Zakaria asked Gladwell to defend his controversial position, and nary a punch was pulled.

Gladwell, author of The Tipping Point, Blink and Outliers, references a growing list of research studies suggesting a link between the head-impact injuries football players routinely endure during practice and games, and debilitating neurological disorders. The most troubling of these studies show evidence of chronic traumatic encephalopathy (CTE) in the brains of former college and professional football players, a disease with similarities to Alzheimer’s. CTE is only diagnosable post-brain death during an autopsy and has also been found in the brains of boxers and hockey players (although medical researchers are getting closer to diagnosing the disease in living adults).

Before the last few years of research, it was commonly thought that only head injuries resulting in a concussion or worse were serious enough to trigger long-term problems. The latest studies are showing that’s not the case—it’s not only the concussive hits that take a toll, but the ongoing subconcussive hits that many players endure multiple times during the course of a game.

A recent study of college football players who had experienced subconcussive hits showed evidence of traumatic brain injury hours after a game and, in some cases, six months later. Researchers administered a blood test to players to track a protein called S100B that indicates damage to the blood-brain barrier. When enough of the protein enters the blood stream, the body attacks it as a foreign invader, producing antibodies that can later re-enter the brain and cause long-term damage like epilepsy and dementia.

Players who had received subconcussive hits during a game had varying levels of elevated S100B in their blood (compared to pre-game blood tests). Tests of those suffering the most hits showed that antibodies to S100B had developed after the season ended, and subsequent MRIs of those players’ brains showed small but measurable changes consistent with brain damage six months after the season. According to researchers, the average lineman endures up to 1,200 subconcussive hits over the course of a season, and the damage appears to be cumulative. A typical four-season college football career could, in light of this research, result in significant damage for some players.

Gladwell mentioned the case of Univeristy of Pennsylvania lineman Owen Thomas, who committed suicide in 2010. An autopsy showed early stages of CTE in Thomas’ brain—just as it was found in the brains of Dave Duerson and Junior Seau, professional players who also ended their lives in suicide. CTE is linked to depression and impulse control disorder, so it is probable—though not certain—that it contributed to Thomas’ death, since he had no documented history of depression.

When asked to comment on a comparison he’d previously made between college football and dog fighting (in 2009, just after Michael Vick was convicted of dog fighting), Gladwell said “I was just struck at the time by the unbelievable hypocrisy of people in football, for goodness sake, getting up in arms about someone who chose to fight dogs, to pit one dog against each other.” He added:

In what way is dog fighting any different from football on a certain level, right? I mean you take a young, vulnerable dog who was made vulnerable because of his allegiance to the owner and you ask him to engage in serious sustained physical combat with another dog under the control of another owner, right?

Well, what’s football? We take young boys, essentially, and we have them repeatedly, over the course of the season, smash each other in the head, with known neurological consequences. And why do they do that? Out of an allegiance to their owners and their coaches and a feeling they’re participating in some grand American spectacle. (CNN – July 20, 2013)

The answer to the problem, according to Gladwell, is that a major university must decide to cancel its football program and set a precedent for others to follow. His ideal candidate is Stanford, a school with both serious academic credentials and a high-powered football program. If a school like Harvard or Yale called it quits, that would be a good start, but it will take a major, bowl-winning program like Stanford to draw an acknowledged line in the sand. (Central to Gladwell’s argument is that elite academic universities will never distinguish themselves via football anyway, but an elite school like Stanford represents a rare combination of academic and sports prowess, and that’s what he believes it will take to catalyze change.)

While it’s difficult to argue with research increasingly showing a link between head impacts routinely suffered during football games and brain trauma, the question is whether we should jump from this evidence–troubling, but also preliminary in nature–to the extreme position of banning the most popular college sport in the nation. Even Gladwell’s position that schools essentially opt out of football seems far-fetched.

Are there perhaps other steps that can and should be taken to reduce the incidence of head injuries, or are we fooling ourselves by thinking that an inherently violent sport like football can be toned down enough to keep players safe from long-term harm? And what about high school and junior high football, and youth programs like Pop Warner? If brain damage can be found in college players, it’s possibly starting much earlier — should these programs also be banned?

Let us know what you think in the comments. I have a feeling this topic will need another article to adequately address, but first I’d like to open the floor to opinions.

[In the interest of full disclosure, I'm an avid and sometimes rabid college football fan.]

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I’m working on a helmet covered with an 8″ layer of Nerf material… inside and out. It may look silly, but the brain is well protected. Of course, the humiliation from wearing one of these “brain-safe” helmets can cause severe mental problems. Okay, ban football, but the football players get to ban journalists.

Go back to the thin leather cap with ear flaps and they will really hesitate to go charging each other with their heads. A couple of busted necks would send the message. No more padding, strappings, tape, and shin guards. I tell you, this will work. Poundage controlled, and we are home free. http://bit.ly/Ut6z82

That’s a good point. I love education but aren’t we fooling ourselves about student-athletes? Why can’t some students go to school for school only? They would be accountable for their decision and they could always consider college later in life.

This is a perfect example of how BHOCARE will punish those who try to stay healthy and reward those who don’t.

I never engaged in any “sport” that demanded deliberate repeated hard contact. BUT, I will be paying higher taxes to pay insurance subsidies and expanded medicaid. Higher insurance rates to pay for those with “pre-existing (usually self inflicted) conditions”.

Lifestyle choices MUST be taken into account and higher rates applied to those who are DELIBERATELY doing things that WILL make them need additional healthcare at some point in the future. That is the ONLY way to eventually get healthcare costs to come down because fewer people are doing things to make themselves sick.

So, any history of playing contact sports, should result in permanent listing has high risk and a requirement to pay higher insurance rates befor the injuries make it impossible for that person to work.

Not only is football a completely senseless destruction of the human body, it costs a fortune for all the non football playing students and their families. The LA Times had done a research study showing the cost of having a college football team – stadium, coaches, trainers, staff, 86 full scholarships, travel, etc. to be around $2600 – $6000 per year per student. if I were paying back tons of student loans, so some guy could play football, I would be having a fit.

And how many of those guys will make it to the pros, stay in the state that gave them the scholarships if they went to a public university, and pay enough taxes to pay for their scholarship – let alone all the other expenses?

These are the same schools whose students can’t get the classes they need to graduate in 4 years as there are not enough sections offered, but the school has enough to pay $5,000,000 for a single coach’s salary? Hmmmmmmmmm.

And then as a previous commenter pointed out, taxpayers get to pay for their healthcare? Mathematically, I want all the science fair winners to get full scholarships. People who could actually learn and retain and use their educations for everyone’s benefit seem a much better investment than crushing some young person’s health forever.

If the pros (who should lose their nonprofit status as well) want people, they should pay for a minor league out of their own pockets and be charged with lifetime healthcare as a cost of doing business. And no more stadiums from taxpayer dollars either!

I don’t know what universities this study touched, but at least at the University of South Carolina (and, presumably, most if not all of the other SEC schools), football pays for itself and then some. A portion of the revenue generated by football is funneled back into the general university coffers.

Actually I believe when they included all the costs, they found less than 10 college programs actually paid for their own costs, let alone all the other teams. Of course, this is the argument most colleges use to justify their programs but if you leave out the costs of building and maintaining the field, benefits for all those extra personnel etc., the numbers do not work. Creative accounting can be used to justify almost anything.

Also I went to a University with recruiting violations that were eventually called out. I accidentally took one of the classes designed for the athletes which was pathetic. 90% of test questions were given in advance with the correct answers written down. One player had a “job” turning on the automatic sprinkler system which paid enough to afford him a Corvette and apartment off campus etc.

The time requirements for playing college football are so intense, how many of these students actually get an education? I could never have missed so many classes for travel and excelled in my classwork.

My first career out of college was as a science teacher and I received a lot of pressure to pass high school players as well. Their sense of entitlement often led to a complete lack of effort and confidence that no effort was required on their part. I was exhorted to find a way to pass a player whose average was in the 20% range who had never turned in a homework assignment. Stood by my grade book and received the most horrendous class schedule possible the following year.

•Fact: Among the supposedly lucrative big-time football programs in the NCAA’s Division I-A, 45 per cent are running deficits averaging around $638,000 annually. •Fact: Ninety-four per cent of Division I-A football programs are running deficits averaging $535,000 per year. •Fact: Thirty-four per cent of all Division I-A men’s basketball programs run annual deficits averaging $250,000. •Fact: Seventy-four per cent of all other Division I men’s basketball programs run annual deficits of close to $200,000.

I’m glad Gladwell made this point and I commend him for being fearless enough to equate the two entities. I wrote a related blog post today because I felt so strongly in his point. As long as money comes from college football (upwards of over $120 million), why will change happen? The worst part to me is the fact that while the NFL has made some safety changes, college football has made hardly any. I don’t really think they care about the student-athletes. Many of them only care about money. It’s really unfortunate. Read more of my thoughts at www.danieltroutman.com/blog and leave comments!

Football can be played safely; it’s the lack of accountability for poor and dangerous blocking and tackling technique that is the problem. Too many coaches have taught it this way or condoned it among their players; Sportscenter has too long glorified the big hits.

A few rules changes which would dramatically increase the penalty for deliberate anything-to-helmet and helmet-to-anything contact, could get rid of the lion’s share of mTBI. Think along the lines of player and/or coach ejections.

@Daryle Hier: school is for learning–and many of these players would not have a chance to go to college otherwise.

@Sensible1: poor argument. The football programs that pay big money salaries more than pay for themselves–they cover the scholarship costs for non-revenue producing sports including women’s sports. It would be easy to give science fair winners full scholarships if people were willing to pay $50 a ticket to get in, plus another $20-30 for a T-shirt and a hat.

Your argument does not allow for any other options which I feel very selfish. If there were other scholarship options put in place instead of this the players could utilize them instead of sacrifice themselves for the sake of American blood lust. Once those players have left the field, you have had your entertainment and will channel surf to the next game but those young men have to survive in the world brain damaged. What would it profit a man to gain the whole world and lose his…mind?

I work in neuroscience so this topic is right up my alley. In short, CTE is a diagnosis looking for a disease. There is no clear specific set of diagnostic criteria. The symptoms attributed to CTE are not at ALL specific to the “diagnosis,” and in fact are easily explained by factors present in the persons who supposedly have CTE, like drug abuse, financial problems etc.

Also there doesn’t seem to be agreement on where the pathology is or should be or will be in the brain, or ANY rhyme or reason as to who gets it and when and why. Or even agreement as to whether it is progressive or not.

And when it became clear that concussion was not even present in some of the persons who reportedly had the condition, the researchers decided, well, okay it is SUBCONCUSSIVE blows that cause it. But that is not borne out in the huge numbers of former athletes who have survived playing various contact sports with no signs of this alleged disease.

Finally, although I could go on, I have three words: Follow the money.